Abstract
Purpose
: To use endosonography to assess the components and lengths of the pelvic floor muscles (PFM) in patients with high imperforate anus (HIA) during laparoscopy-assisted colon pull-through (LACPT).
Methods
: Three male infants (Nos. 1, 2, and 3) with HIA and rectourethral fistula were examined. A proctoscopic ultrasonography probe (7.5 MHz, 12 mm in diameter) was inserted along the course of the proposed pull-through canal under laparoscopic control to assess the structure and thickness of the main components of the PFM - that is, the pubococcygeus (PC), puborectalis (PR), muscle complex (MC), and external sphincter (ES) - and measure the length of the entire PFM.
Results
: Weight at LACPT was 8.0 kg in No. 1, 5.9 kg in No. 2, and 8.5 kg in No. 3. In all cases, the proposed pull-through canal lay centrally within the PFM on endosonography. The length of the PFM was 42 mm in No. 1, 31 mm in No. 2, and 39 mm in No. 3.
Conclusion
: Intraoperative endosonography during LACPT permitted examination of the PFM in patients with HIA. By confirming the exact position of the probe laparoscopically, we were able to identify the true size, structure, and length of the PFM (in particular the PC and PR).
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